Congenital obstructive distal urethral membrane.
We present a rare case of complete distal urethral obstruction caused by a distal meatal membrane in a newborn boy. A cystic lesion of the distal penis was detected and excised, revealing a hypospadiac urethra. Further examination showed bilateral vesico-ureteral reflux with a dilated posterior urethra and urethral lesion, suggesting posterior urethral valves (PUV); these were confirmed at 2 months and resected endoscopically. At 16 months a left nephrectomy was performed due to impaired renal function on that side; there was no longer reflux on the right side. The obstruction probably did not become severe until late in gestation, but still led to functional loss of one kidney. The PUV do not seem to have been the cause of renal deterioration. The cystic lesion may have been a remnant of the cloacal membrane, but this is difficult to prove histologically.
Schimke
Christa M
CM
Department of Pediatric Surgery, Paracelsus Medical University, Salzburger Landeskliniken, Müllnerhauptstrasse 48, A-5020 Salzburg, Austria. c.schimke@salk.at
Boemers
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Detlefsen
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